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Sentenced to Darkness

Electricity and Chronic Patients in the

Unrecognized Bedouin villages in the Negev

December 2008


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""""Sentenced to DarknessSentenced to DarknessSentenced to DarknessSentenced to Darkness""""

Electricity and Chronic Patients in the UnrecognizedElectricity and Chronic Patients in the UnrecognizedElectricity and Chronic Patients in the UnrecognizedElectricity and Chronic Patients in the Unrecognized

Bedouin villages in the NegevBedouin villages in the NegevBedouin villages in the NegevBedouin villages in the Negev

December 2008December 2008December 2008December 2008


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Sentenced to DarknessSentenced to DarknessSentenced to DarknessSentenced to DarknessElectricity and Chronic Patients in the Unrecognized BedouinElectricity and Chronic Patients in the Unrecognized BedouinElectricity and Chronic Patients in the Unrecognized BedouinElectricity and Chronic Patients in the Unrecognized Bedouinvillages in the Nvillages in the Nvillages in the Nvillages in the Negevegevegevegev

WritingWritingWritingWriting: Wasim Abbas and Shir Alon

AbstractAbstractAbstractAbstract: Wasim Abbas

ResearchResearchResearchResearch: Dr. Ye'ela Ra'anan The Regional Council for the

Unrecognized Villages

Wasim Abbas Physicians for Human Rights

PhotosPhotosPhotosPhotos: Physicians for Human Rights

TranslationTranslationTranslationTranslation: Noga AlmiDesigDesigDesigDesignnnn: David Moscovitz

ProductionProductionProductionProduction: Gafrurei Dafdefet

This document has been produced with the financial assistance of the European

Commission.

The contents of this document are the sole responsibility of Physicians forPhysicians forPhysicians forPhysicians for

Human RightsHuman RightsHuman RightsHuman Rights---- IsraelIsraelIsraelIsrael and can under no circumstances be regarded as reflecting

the position of the European Commission.


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AbstractAbstractAbstractAbstract

Half of the Arab-Bedouin population in the Negev lives today in villages

the government consistently refuses to recognize.

Some of the villages existed before the establishment of the State of Israel

and others are a result of population transfers in the 1950's, under the

military regime. In order to put pressure on the Bedouin residents and

concentrate them in townships established by the state, the government

abstains from providing them with basic infrastructures and services

water, electricity, roads and health clinics as long as they reside in their

villages. The refusal to recognize the villages is a deliberate discrimination

of the residents and a violation of human rights. The prevention of basic,

crucial services from the residents of the unrecognized villages in the

Negev inflicts upon them severe health problems that sometimes cost

them their lives.

The refusal to connect the villages to the electricity infrastructure is one of

the most severe violations not only because it denies the right to health

from all the residents, sometimes while risking their lives, but mainly

from the chronically ill, the children and the elders. Without electricity,

the residents of the unrecognized villages cannot store food and

medications or maintain reasonable living conditions, such as safely

heating or cooling the house, maintaining it clean and hygienic or using

electrical medical equipment required for their recuperation.

This discrimination is especially overt when we deal with the chronic

patients. For them, electricity is a crucial part of their treatment. A

mapping prepared by PHR-Israel and the Regional Council for the

Unrecognized Villages in the Negev, shows that 21% of the entire

population are chronic patients in need of electricity on a regular basis as

part of their treatment. Electricity is needed for various purposes storing

medicines that require refrigeration, such as insulin injections for


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diabetics; operating electrical medical appliances, such as Ventolin for

those who suffer from asthma or inhalation and respiration support

appliances for other respiratory patients; cooling or heating the house in

order to create conditions necessary for recuperation. The findings of themapping show that the lack of electricity caused the deterioration of

around 70% of the patients, out of whom 2% died. When we examined the

identity of those affected, we found that 31% of the women who live in the

unrecognized villages suffer from chronic diseases. Among the children,

the measure was 20% (their measure in this population is 58%).

The population of the unrecognized villages is the only population fromwhich electricity is prevented. Recurring applications of chronic patients

from the unrecognized villages, requesting to connect their houses to the

national electricity network in order for them to use electrical medical

appliances, met a decisive refusal on the part of the government.

According to the government, without the right certificate of approval

from the planning authorities an approval that cannot be obtained as

long as the villages are unrecognized it cannot connect them to the

electricity network. Yet, this claim doesnt hold water: private farms in the

Negev and illegal settlements in the occupied territories that have no legal

planning status were connected to the electricity network during the

building process. Therefore, the refusal of the state to connect the villages

to the electricity network is a deliberate discrimination, originating from

the ethno-national attribution. When the state refuses to connect even the

homes of those patients in need of electricity for medical treatment and

saving lives, this discrimination is a pure bureaucratic evil.

Mhamad Abu-Ashiba, 79 years old, resided in Umm-Matnan, a village

that had been recognized lately, near Arara. However, the village had not

yet been connected to basic infrastructures, amongst them the electricity.

Four years ago he became ill with an acute chronic lung disease (Chronic

Obstructive Pulmonary Disease) ever since he had been ventilated using a


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gas canister around the clock. In September 2006, his condition

deteriorated and he was hospitalized. Upon his release, his physicians

instructed a BIPAP machine treatment (an electric device which regulates

the pressures of air flow in the lungs and prevents its blockage). Thephysicians determined that the machine is crucial for Abu-Ashibas life

and health, and that it does not have any medical alternative. The

machine can be leased from Yad Sarah, yet there was no point in doing

so since electricity is needed for its operation: like all houses in the village,

the state refuses to connect Abu-Ashibas house to the national electricity

network. Unable to use the machine, Abu-Ashibas condition deteriorated

and he was admitted to the hospital once more. There he was connected tothe BIPAP machine until his condition improved. Yet, after returning

home, his condition deteriorated again.

Recurring requests from Physicians for Human Rights to the Ministry of

Health, the Ministry of National Infrastructures and the Ministry of

Interior, demanding to connect his house to the electricity network due to

his medical condition, failed. The Minisrty of National Infrastructures and

the Ministry of Interior claimed that his house was built illegally and

therefore cannot be connected. The Ministry of Health pointed out the

need for a solution, but took no measures in order to advance such a

solution. Without electricity Abu-Ashibas condition continued to

deteriorate until on 23.4.2008, after much suffering, he passed away.


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BackgroundBackgroundBackgroundBackground

The purpose of this position paper is to present a wide phenomenon of

violation of the right to health of the Arab-Bedouin residents of the

Unrecognized Villages in the Negev. This document will focus on the

violation of the right to health of a large group of chronic patients and

respiratory chronic patients, caused by the states refusal to connect their

homes to the national electricity network.

More than half of the Arab population in the Negev approximately

83,000 people live in 45 villages which are not recognized by the state,

and its planning status has not been determined. Lately, ten villages have

been recognized within the Abu-Basma Regional Council. However, none

of these villages have been connected to basic infrastructures and its

residents continue to suffer from discrimination in their living conditions,

connection to the water and electricity networks, road-building and health

services.

The connection to the electricity is crucial to health, especially for chronic

patients who need it as part of their treatment, including Asthma

patients, diabetes patients and other respiratory patients. A condition that

can easily be treated becomes complicated, and sometimes dangerous,

requiring recurring admissions to the hospital. Chronic patients, old and

young, are denied from the right, and the possibility, to use electricalmedical appliances, to store medications, vaccinations and food in their

homes. At best, they are forced to long period admissions. In other cases

they are sentenced to death due t o an ongoing deterioration in their

condition.


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The Problem of Electricity CThe Problem of Electricity CThe Problem of Electricity CThe Problem of Electricity Connectiononnectiononnectiononnection

All the unrecognized villages, and those which have recently been

recognized within the Abu-Basma regional Council, are not connected to

the national electricity network. The existing connections were initiated

and paid for by the residents. Some of them use generators that work

between one to four hours a day, or expensive solar systems that operate

only on sunny days and their output is poor. Most residents cannot

maintain alternative systems of electricity due to the high cost, and

therefore remain without electricity. The few clinics recently built due to

Supreme Court ruling1 are still not connected to the electricity network,

but only to a generator operating during the opening hours. Thus,

medications that require refrigeration or basic medical appliances cannot

be used.

The population of the unrecognized villages is the only population which is

deprived of a connection to electricity. The explanation of the different

authorities, that they cannot connect the houses due to an unresolved

planning status, turns out to be an unfounded excuse, since that same law

is not activated when it comes to the occupied territories and the

individual farmsteads scattered throughout the Negev, whose dwellers

enjoy a connection to the electricity network and all the other

infrastructures, although their planning status has not been resolved.

Chronic Patients do not Receive Proper Treatment

From February-May 2008 Physicians for Human Rights and The Regional

Council for the Unrecognized Villages in the Negev, conducted a field

research in the villages. The research was conducted using a cluster

1Supreme Court ruling 4540/00 Physicians for Human Rights, The Association for Civil Rights inIsrael, The Regional Council for the Unrecognized Villages in the Negev and the Negevcoexistance forum.


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sampling: two villages were randomly selected, in each of which a

neighborhood was randomly selected, where all the residents were

examined. The sample included 404 participants. Villages that suffer from

exceptional environmental hazards, such as the proximity to RamatHovav, were excluded from the research.

Table 1: The Distribution of the Sample Population According to Age and SexTable 1: The Distribution of the Sample Population According to Age and SexTable 1: The Distribution of the Sample Population According to Age and SexTable 1: The Distribution of the Sample Population According to Age and Sex

GeneralGeneralGeneralGeneralNumberNumberNumberNumber

PercentagePercentagePercentagePercentagefromfromfromfromPopulationPopulationPopulationPopulation

Number ofNumber ofNumber ofNumber ofPatientsPatientsPatientsPatients2222

PercentagePercentagePercentagePercentageof Patientsof Patientsof Patientsof Patients

PercentagePercentagePercentagePercentagefrom Patientsfrom Patientsfrom Patientsfrom Patients

ChildrenChildrenChildrenChildren 255 63% 50 20% 58%MenMenMenMen 69 17% 11 16% 13%WomenWomenWomenWomen 80 20% 25 31% 29%TotalTotalTotalTotal 404 100% 86 100%

The research shows that 21.2% of the residents in the villages are chronic

patients, who need electricity as part of their treatment.3 70% of the

chronic patients, who constitute 15% of the entire population, suffer long

and hard due to the lack of electricity, which can also cause deterioration

in their condition and death. Out of the entire patients in the research,

47% are chronic patients who need extended, ongoing treatment. The data

shows that 50% of the patients suffer from Asthma. 20% of them are

chronic respiratory patients who regularly need inhalation and oxidation

machines, including children and elders who have no access to electricity,

oxygen generators or respiratory supporters.

2This refers only to the chronic patients hurt by the lack of electricity.3The mapping of the chronic patients in both villages was conducted by the councils field coordinator.


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Table 2: Chronic Patients and Types of IllnessesTable 2: Chronic Patients and Types of IllnessesTable 2: Chronic Patients and Types of IllnessesTable 2: Chronic Patients and Types of Illnesses

PercentagePercentagePercentagePercentageofofofofPopulationPopulationPopulationPopulation

PercentagePercentagePercentagePercentageof theof theof theof thePatientsPatientsPatientsPatients

MultiplicityMultiplicityMultiplicityMultiplicityooooffffIllnessesIllnessesIllnessesIllnesses4444

PercentagePercentagePercentagePercentageofofofofPopulationPopulationPopulationPopulation

Percentage ofPercentage ofPercentage ofPercentage ofthe Patientsthe Patientsthe Patientsthe PatientsNumberNumberNumberNumberofofofof

PatientsPatientsPatientsPatientsType ofType ofType ofType ofIllnessIllnessIllnessIllness

11%50%438.6%40.7%35AsthmaAsthmaAsthmaAsthma1%3%30.2%1.2%1RespiratoryRespiratoryRespiratoryRespiratory

otherotherotherother4%

17%151.7%8.1%7DiabetesDiabetesDiabetesDiabetes

2%12%101.2%5.8%5HeartHeartHeartHeartDiseaseDiseaseDiseaseDisease

0%1%10.2%1.2%1

RRRRheumatismheumatismheumatismheumatism

2%8%70%0%0BBBBloodloodloodloodpressurepressurepressurepressure

2%9%82%9.3%8

MentalMentalMentalMental

0%2%20.2%1.2%1

CancerCancerCancerCancer

1%6%50.7%3.5%3BloodBloodBloodBlood otherotherotherother

3%15%132.5%11.6%10OtherOtherOtherOther3.7%17.4%15MultiplicityMultiplicityMultiplicityMultiplicity

of Illnessesof Illnessesof Illnessesof Illnesses

100%86TotalTotalTotalTotal

Chronically ill Children

63% of the sample is children under the age of 20 - 51% boys, 49% girls.

20% of the children suffer from chronic diseases and the electricity

shortage harms them. The sick children suffering from electricity shortage

constitute 58% of the population of chronic patients.

Yassin is a 3.5 years old child, from Al-Surra village, the firstborn of Iad (31

years old, unemployed) and Sarah (27). Yassin suffers from Asthma ever since he

was 6 months old. He suffers strong and frequent seizures 4 times a month on

average and needs electrical inhalation. When he has a seizure at night his

4Patients who suffer from additional illnesses, apart from the above mentioned illness.


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father operates the generator in order to use the inhalation machine. When he

has a seizure in the morning, his father drives him to the nearest clinic, situated

in Kseifah. If the child has a seizure when the clinics are closed, his father is

forced to take him to the medical emergency center in Arad. Every visit costs 75

Shekels. In order to reach the clinic or the emergency center the father has to

drive a car, which he does not have, or walk a five kilometers distance with the

child up until the main road, where they have to wait for a bus. After opening the

medication kit necessary for inhalation, it has to be kept in refrigeration. The

family keeps the inhalation kit in a cool place under the cupboard or in the

freezer purchased for that purpose, yet does not operate most of the time, only in

the short while when the generator operates. Without permanent refrigeration,

the medication loses its effectiveness and, with time, is ruined. The childscondition deteriorates when he suffers from high fever. The Asthma seizures are

strong and in the past, he was forced to be admitted to hospital for a period of one

to two weeks each time.

Abir, an 8 years ol child from the unrecognized village of Al-Sara, became ill with

bladder cancer three years ago. The treatment included visits to the hospital

twice a week. Yet, due to the lack of electricity which didnt allow for a clean

environment and refrigeration of medications she was admitted to Soroka

hospital for almost two years in a row. Today, Abir still needs a clean and air-

conditioned environment and needs to be safeguarded from physical contact with

other people. Abir goes to school every-day and the desert environment hot

during the day and cold at night worsens her health.

Ill Women

Women constitute 20% of the survey population. The lack of electricity

hurts women more than any other population. The research shows that

31% of the women residing in the two unrecognized villages suffer chronic

diseases, which are worsened due to the lack of electricity.

Wadha Al-Atrash, a 32 years old woman from the unrecognized village of

Khashm Zinna suffers from acute Asthma and needs to ise an electrical ventolin


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on a regular basis. Since her house is not connected to the national electricity

network, and due to the fact that there is no clinic in her village, she is forced to

visit the nearest clinic in Segev-Shalom. The ill Wadha has to walk a 2

kilometers distance to the main road, and then exchange two buses in order to

reach the clinic, a journey that takes about four hours. In the past three years,

due to an ongoing lack of oxygen, her heart was severely damaged and today she

is under constant medical surveillance.

Wadha has a 7 years old child, also suffering from Asthma; Every time he is

exposed to a cold weather, he has to be taken to a clinic in order to enable him to

breathe using an inhalation machine.

Unable to receive the proper treatment, patients have to rely on less

effective alternatives temporary solutions that not only endanger their

lives but also entail higher expenses, to both the patient and the state, due

to recurring admissions to hospitals. In order to use a simple electrical

Ventolin machine, these patients need to go to the nearest clinic, which is

usually situated a few kilometers away from the main road. The patients

have to walk a few kilometers by foot in order to get there, and then use

public transportation. Moreover, children and elders need to be driven by

a relative, who misses a days salary in order to aid the patients.

Respiratory Patients In Need of Oxygen Generators or a

BIPAP Machine

Respiratory chronic patients, who need electric respiration machines on aregular basis, are the main victims of the states refusal to connect the

villages to the national electricity network. Lacking regular electricity

supply to their homes, they cannot receive basic and necessary treatment,

and their right to health is brutally violated.


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Due to the poor living conditions in the unrecognized villages, the rate of

those suffering from respiratory diseases is especially high, resulting in an

increased need for electrical medical appliances.

An oxygen generator is a domestic electric appliance which separates the

oxygen from the other gases in the air and releases a high concentration of

oxygen to the patient. When usage of the generator is prevented, as is the

case in the unrecognized villages, respiratory patients are forced to use

ready-to-use oxygen balloons. Some patients use five balloons a week,

which they purchase from private companies. The HMOs fund 80% of the

cost and the rest is paid by the patient. This is an atrocious waste for theHMOs, especially when one takes into account the need to supply the

balloons to the patients homes, sometimes, a few times a week. The

patients medical condition is utterly reliant upon this delivery, which is

sometimes delayed or goes missing due to the bad roads in the

unrecognized villages. An electrical oxygen generator, on the other hand,

reassures an ongoing, secure supply of oxygen, independent of suppliers

and recurring balloon replacement.

Slama Abdalla alamarani, about 70 years old, is residing in Qasr Assir (Al-

Hawashle), a village in the process of becoming recognized that has not been

connected to infrastructures yet. Mr.alamarani has been suffering from a chronic

lung disease in the past two years, and due to deterioration in his condition in

the last five months, his physicians ordered him to use a domestic inhalation

machine (an oxygen generator). Although he received the machine from Yad

Sarah he still suffers from breathing, since the machine does not work due to

a lack of electricity at night. Apart from breathing problems, he also suffers from

diabetes but cannot store Insulin in his house since he does not own a

refrigerator. From time to time his condition deteriorates and he has to be

admitted to hospital. This is an ongoing situation, with no solution in sight.

The condition of the patients in need for a BIPAP machine is much more

dangerous. This is an electric machine that regulates air flow pressure in


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the lungs and prevents its blockage. A patient who needs the BIPAP

machine has no alternative non-electric treatment. Indeed, the respiratory

patients who need it use oxygen balloons, but these cannot replace the

machine. Without it, their condition deteriorates rapidly and they areforced into frequent hospital admissions. These machines are usually

supplied by HMOs or organizations such as Yad Sarah, yet lacking a

connection to the electricity, they cannot be used.

The lack of electricity prevents the elderly and the ill of the right to stay at

home, with their family members a right that every elderly has and

forced them into long periods of hospitalization which entail a highexpenditure of public money. This is especially difficult in the Bedouin

society, where it is not customary to send older members of the family to a

parents home or a nursing home. The older members of the family stay in

their familiar environment, with their family who take care of them, thus

remaining an active and important part of the social-domestic fabric. The

Bedouin familial structure disintegrates when the head of the family is

forced into long-period hospital admission and the burden of the recurring

admissions falls on his family.

Mitab Al-Ktzazi, 70 years of age, resides in the unrecognized village of Umm Al-

Hieran. He is a father of five small children and lives on an allowance. Seven

years ago he was diagnosed with COPD an acute chronic lung disease. Two

years ago his condition deteriorated and his physician ordered him to use the

BIPAP machine. His physician, Professor Abu-Shakra from the Sorokahospital, wrote a professional evaluation to PHR-Israel, indicating that the

patient has to be connected to oxygen 24 hours a day, and also to the BIPAP

machine at least 16 hours a day a regular activation of the BIPAP machine

based on a regular supply of electricity is a necessary, most essential treatment

which improves and saves lives.5 On Februaty 28, 2008, Mr. Al-Ktzazi was

admitted to hospital due to a severe deterioration in his condition. He was

hospitalized for over a month. His physicians did not release him to his home

5 Professor Abu-Shakra Mahmud, a letter to PHR-Israel, 08.05.2007.


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since they feared deterioration. Recently he was released from hospital after his

family, who lives on a 3200 shekels pension, had rented him a one room

apartment in Rahat.

Alshimah Abu-Sbieh is a seven month old baby from the Al-Bat village (Marit).

The village was recognized on January 2008, yet the state had not yet connected

it to the infrastructures. She was born with a considerable retardation due to an

insufficient development of the brain, which is manifested by an expansion of the

front and rear brain ventricles and lacking the corpus callosum the longitudinal

fissure that connects the left and right cerebral hemispheres and facilitates

communication between the two hemispheres.

The toddler is frequently hospitalized and is under surveillance in the Sorokapediatric outpatient ward. The disease causes an extreme deficient functioning of

the brain, due to which the body does not hold oxygen in the blood (SAT). That is

why Abu-Sbieh needs an oxygen generator treatment 24 hours a day. In order to

operate the generator, the family bought a generator which operates all day. The

family thus faces expenses that she cannot bare due to the fuel consumption for

the daily operation of the generator. The response of the Abu-Basma regional

council to our request to connect the Abu-Sbieh family to the national electricity

network since the village belongs to its area of jurisdiction was as follows: The

Abu-Basma regional planning and building council has no authority to issue a

building permit to the Abu-Sbieh residency, which is a necessary condition for an

electricity connection

And in the meantime, the toddler is fighting for her life.

Both patients need a regular, daily, 24 hours a day connection to the machine in

order to ensure their medical stability. Since both of them live in unrecognized

villages or in a village that is still not connected to the infrastructures, their

homes are not connected to the electricity and they cannot use the machine and

cannot receive the necessary treatment. Then, they have to be rushed and

admitted to the hospital in Beer-Sheva. In the past year, Mr. Al-Ktzazi was

admitted at least ten times.

In conclusion, the cases of Mr. Al-Ktzazi, Mr. Abu-Ashiba, Wadha and the

Abu-Sbieh child, and all the other chronic patients living in the unrecognized


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villages, are examples of a distorted, inhumane and hopeless reality. The

necessary, right treatment is prevented from the patients and causes direct

deterioration of their condition. The wandering in unfitted roads on the way to

the hospital every time that their condition is deteriorated is unnecessary and

endangers their health. One should remember that long periods of admission

cause for a heavy load on public money, expenses that could have been prevented

were the patients able to receive treatment at home, beside their families.


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The States OThe States OThe States OThe States Obligationbligationbligationbligation

Accessibility to electricity is a decisive condition for health, thus it is the

states obligation to provide it to its residents in order to ensure their right

to a healthy life. The right to health is anchored in Israeli law and in

international conventions signed by Israel, emphasizing that the right to

health does not only mean accessibility to medical treatment, but also the

fulfillment of a complex of environmental conditions and basic services,

electricity being one of them, which enable a healthy living.

Moreover, the UN committee on economic, social and cultural rights, bases

the right to health on the principle of accessibility and availability of

health services for all, in an equal manner. The residents of the

unrecognized villages in the Negev are the only ones from whom the

connection to electricity and other basic infrastructures is prevented, in

order to force them to leave their lands and move to the townships built by

the state. This situation, in which a necessary, sometimes life-savingmedical treatment is prevented from a patient, due to the states refusal to

connect his home to the electricity, is invalid and discriminative and

violates basic living and health rights. The state must immediately

connect the homes of these patients to the electricity network in order to

allow them to fulfill their right to health and to living a life in dignity.

Many of the respiratory chronic patients are elders and children, and TheInternational Covenant on Economic, Social and Cultural Rights by the

UN especially emphasizes their needs as a vulnerable population. General

Comment No. 14 indicates the obligation to spare elders avoidable pain

and enable them to die with dignity. The meaning of this comment is

undoubtedly to allow each person to remain in his familiar environment,

beside his family, and maintain an independent way of life as long as

possible.


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A full description of the rights of the elderly appears in comment number

6, indicating that the state has the duty to protect the rights of the elderly,

by all available means. Comment number 6 also acknowledges thathousing for the elderly must be viewed as more than mere shelter and

that, in addition to the physical, it has psychological and social

significance which should be taken into account. Accordingly, national

policies should help elderly persons to continue to live in their own homes

as long as possible, through the restoration, development and

improvement of homes and their adaptation to the ability of those persons

to gain access to and use them, in order to maintain the traditionalfamilial structure and the elders basic right to dignity.

The rights of children are ensured as well, being humans with special

needs and citizens of the state of Israel. Amongst the rights is the right to

health, anchored in the Israeli law as well as in international conventions.

The UN Convention on the Rights of the Child (1989), which was ratified

by Israel in 1991, determinates in the issue of the right to health:

States Parties recognize the right of the child to the enjoyment of the

highest attainable standard of health and to facilities for the treatment of

illness and rehabilitation of health. States Parties shall strive to ensure

that no child is deprived of his or her right of access to such health care

services. (Article 24(1))

In the Israeli law corpus, the right to health is evident from the Basic

Law: Human Dignity and Liberty (1992), which does not merely prohibits

the violation of life or body of any person as such, but also indicates that

all persons are entitled to protection of their life, body and dignity.

The state succeeded in anchoring the principles detailed in the

international convention in local laws. The Patients rights act (1996)


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explicitly determines that A patient shell be entitled to proper medical

care, having regard both to its professionalism and quality, and to the

personal relations incorporated in it.6 And that No medical facility or

clinician shall discriminate between patients on grounds of religion, race,sex, nationality, country of birth, or other such grounds.7 In addition, the

National Insurance Law (1994), which regulates the HMOs obligation to

grant medical treatment to the citizens of Israel and is based on the

principle of equality, determines that: The health care organizations are

required to supply all the services enumerated in the standardized basket,

within reasonable time and distance from the insured persons homes.

One can see that according to these laws, the chronic patients who are notconnected to electricity are not receiving the proper treatment to which

they art entitled by law. On the contrary, the lack of adequate

infrastructures deteriorates their medical condition and dramatically

harms their health. In addition, we stand before a harsh violation of the

non-discrimination principle in providing health services, as indicated in

the law. The medical appliances necessary for the patients are accessible

and available, yet since the patients are Arab-Bedouin; its utilization is

prevented from them.

Indeed, the Israeli law does not explicitly ensure the elders right to live or

die with dignity in their homes, beside their family, yet this right directly

stems from the states obligation to provide adequate access to health

services and from every persons basic right to live in dignity. Inasmuch as

the choice to remain at home and receive nursing services is open for every

Israeli citizen, it should be open for the Arab-Bedouin citizens residing in

the unrecognized villages in the Negev.

6Clause 5.7Clause 4.


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The States TreatmentThe States TreatmentThe States TreatmentThe States Treatment

Despite the states obligation towards the international law and its laws,

she renounces its responsibility to the situation. She categorically refuses

to connect the homes of the patients to the electricity network, yet does

not provide alternative solutions, thus renounces its obligation to ensure

the realization of the basic rights of its citizens. PHR-Israel applied on

behalf of Mr. Al-Ktzazi, the Abu-Sbieh child and Mr. Abu-Ashiba to the

states authorities, requesting an immediate intervention, but received

laconic and evasive answers, in which the main argument was that the

connection to the electricity is not possible since the homes were built

without building permits and illegally.8

The electricity company, a national company committed to provide

electricity to the citizens of the state on an equal basis, refuses to connect

the homes of the patients claiming that they have an unresolved legal

status and transfers the responsibility to government offices theMinistry of Interior and the Ministry of National Infrastructures. The

Ministry of Health, legally responsible for public health, transferred the

cases to other offices, although Professor Avi Israeli, The Director General

of the Ministry of Health pointed out in a letter he addressed to the

Ministry of Interior and the Ministry of National Infrastructures in the

matter of Mr. Al-ktzazi, that even though I am not familiar with the

facts and meanings, on your side, of this specific case from a human,humanitarian and medical point of view, it is clear to us all that we must

try and assist, as much as possible, to resolve this case.9

8 In the case of Mr. Al-Ktzazi: letters to Avi Israeli, Director General, Ministry of Health; Hezi Kugler,Director General, Ministry of National Infrastructures; David Cohen, in charge of the Southern district ,

Ministry of Interior.9 Professor Avi Israeli in a letter to Mr. Ran Blinkov, Director General, Ministry of Interior and Mr.Hezi Kugler, Director General, Ministry of National Infrastructures, a copy received at PHR-Israeloffice on 27/2/2007.


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The Ministry of Interiors position, refusing to connect the homes of

patients whose right to health is violated due to the policy of refusal to

connect the villages to the electricity network, was justified in the

Supreme Court ruling 8062/05 in the matter of Inas Al-Atrash. The judgesexplicitly ruled that the planning and building laws justify violation of

human rights.10 In that same ruling, dealing with the destiny of a child

suffering from cancer who needs electricity in order to maintain a cool and

hygienic environment in her home and to allow her to store the

medications in refrigeration, judges Aharon Barak, Dan Gronis and Dorit

Beinish ruled against Inas right to health, since her parents chose to live

in an unrecognized village, knowing it has no electricity. This ruling isarbitrary and does not reflect reality since Inas family, like most of the

residents in the unrecognized villages, has been living in the village for

many generations, before the establishment of the Israeli state, but the

state does not acknowledge it. It is not a matter of Choosing. Moreover,

in conditions of poverty, unemployment and a harsh daily reality, leaving

the village means giving up the only support source of the family the

extended family and the community.

10The starting point of the discussion is that due to a prohibition in the law (clause 157a to the planningand building law, 1965) the petitioners houses cannot be connected to the electricity networkDavid Cohen, a letter to Yael Vidan, PHR-Israel, received at 15/03/2007.


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Summary and RecommendationsSummary and RecommendationsSummary and RecommendationsSummary and Recommendations

This position paper presents an intolerable situation, in which the state

endangers the lives of her citizens, ill and elders. As time passes by, their

medical condition deteriorates and the state authorities do not offer any

solution.

Every person has the right to health, adequate care and access to the best

medical services the state can provide. Yet, the patients residing in the

unrecognized villages find themselves in an unacceptable situation the

appropriate treatment is accessible, yet they cannot use it due to the

states refusal to connect the villages to the electricity network. This

refusal, together with the lack of other basic infrastructures such as

water, sanitation and health services, is part of ongoing ethno-national

discrimination, from which the Bedouin residents suffer more than 60

years.

There is no doubt that the land problem is a complex one, yet we maintain

that the state has to place the health of its citizens above all political

considerations, and that using health services as a means of pressure on

the Bedouin population in order to force them to move to townships

established by the state is morally and legally wrong.

The states authorities use the planning and building law in theunrecognized villages as a means of evading its responsibility a moral

and a legal responsibility to provide proper, equal health care to all its

residents. The state does not make sufficient efforts to provide solutions

for the chronic patients residing in the villages, especially the ones who

need a regular supply of electricity. It should be noted that the cost of the

connection to tax payers is less than the expenses required in the current


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situation be it the provision of oxygen balloons or the funding of long

hospitalization periods.

PHR-Israel and The Regional Council for the Unrecognized Villages in the

Negev view this policy of service and basic infrastructure prevention asinfected with discrimination, stemming from invalid motivations the

expulsion of the Bedouin residents from their lands and their

concentration in townships. Therefore, every move stemming from this

policy is invalid, and must be ended. Since we know that this aim is still

far, we recommend taking the following actions without delay:

Change the discriminatory policy toward the Arab-Bedouinresidents and acknowledge them as residents with equal rights.

The problem of the unrecognized villages should be solved in

accordance with the residents and should, by no means, affect the

provision of basic services, necessary for their health, such as

electricity and water.

The villages must be immediately connected to the electricity

network, prioritizing the homes of respiratory chronic patients,

diabetics and every chronic patient who needs electricity, before

their condition deteriorates even more. As long as the state does

not provide them with this solution the lives of these people are

in danger.


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The Regional Council for the Unrecognized Bedouin Villages in Negev(RCUV)

was founded in 1997, as the elected popular leadership of the local village committees

and represents the village residents. The High Follow Up Committee for the Arab

Citizens of Israel recognized the RCUV and its chairman as official members. The

RCUV acts as the representative body for the residents of the unrecognized villages:

deals with the different decision makers, works to empower the community, conducts

a judicial rights-based struggle, submits alternative plans for the Negev, produces

an infrastructure of information on the villages for various entities, and more.

Tel: 08-6283043 | Fax: 08-6283315

Address: 47 Haatsmaout St. | P.O.B 10002 Beer-Sheva 68135

Mail: rcuv rcuv@gmail com | Site: www rcuv net

Physicians for Human Rights-Israel (PHR-Israel) believes that every person has

the right to health in its widest possible sense, as defined by the principles of human

rights, social justice and medical ethics. It is the responsibility of the State of Israel

to ensure the fulfillment of this right in an egalitarian manner for all populations

under its legal or effective control: residents of Israel who are eligible for National

Health Insurance, Bedouin residents of unrecognized villages in the Negev desert,prisoners and detainees, migrant workers, refugees and asylum seekers, and

Palestinian residents of the occupied Palestinian territory.

Tel: 972-3-6873718 | Fax: 972-3-6873029

Address: 9 Dror St., Tel Aviv-Jaffa 68135, Israel

Mail: [email protected] | Site: www.phr.org.il

ISSN # 0793-6222

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